Are GLP-1s Right for Your Child?

Should my child be on a GLP-1?

If you've searched GLP-1 medications online, you've probably come away more confused than informed. Some describe them as miracle drugs and wish they had been available when they were younger. Others say they're dangerous and should never be given to children.

Neither is the full story.

The question isn't whether GLP-1s are good or bad. It's whether, for your child, at this point in their journey, the potential benefits outweigh the potential risks.

First, what problem are we actually trying to solve?

Obesity is a chronic medical condition that changes how the body functions. However, the term is so often used to describe how a body looks that people overlook the biological changes happening underneath.

Obesity changes how the brain regulates hunger and fullness, makes it harder to lose weight, and increases the risk of conditions such as type 2 diabetes, fatty liver disease, high blood pressure, sleep apnea, and high cholesterol.

A child can, and should, feel confident at any size. But confidence alone doesn't reduce the risk of fatty liver disease or prediabetes.

The focus should be on what gives your child the best chance of growing up healthier.

Who are GLP-1 medications for?

The American Academy of Pediatrics recommends considering GLP-1s, alongside intensive health behavior and lifestyle treatment, for adolescents who:

• are 12 years or older
• have obesity (BMI ≥95th percentile)
• would benefit from additional treatment beyond lifestyle changes alone

The potential benefits, risks, and alternatives should always be discussed with the child's healthcare team.

Who are they not for?

Many children don't need medication immediately, and some improve with intensive lifestyle treatment alone.

GLP-1 medications generally aren't appropriate for adolescents who:

• do not have obesity
• have an untreated eating disorder
• have a personal or family history of medullary thyroid cancer (MTC) or MEN2
• are pregnant

This isn't a complete list. Your child's healthcare team will also consider their medical history, overall health, and individual circumstances.

Which GLP-1 medications are approved?

Two GLP-1 medications are FDA approved for treating obesity in adolescents:

• Wegovy® (semaglutide)
• Saxenda® (liraglutide)

You may also hear about Zepbound® (tirzepatide), which some specialists prescribe off-label in selected situations. It is not currently FDA approved for treating obesity in children.

You may also hear about compounded GLP-1 medications. We do not recommend these for children. They are not FDA approved, and the quality, potency, and dosing can vary between products.

What side effects should we expect?

The most common side effects include:

• nausea and vomiting
• constipation or diarrhea
• stomach discomfort

Most are mild, temporary, and improve as the body adjusts, especially when the dose is increased gradually.

More serious, but much less common, risks include gallbladder disease and pancreatitis, which is why regular follow-up is important.

Because children are still growing, treatment should always include monitoring of growth, nutrition, side effects, and overall health, not just weight.

If your child starts medication, this matters most

GLP-1 medications don't teach children how to eat well, build confidence, create routines, or develop a healthier relationship with food.

What they can do is reduce food noise, making it easier for children to practice habits that previously felt out of reach.

When constant hunger is no longer shouting all day, children finally have the mental space to build healthier habits.

That's the opportunity.

It's a window of time to build regular meals, prioritize protein and fiber, improve sleep, become more active, and create routines that can last long after the medication is reduced or stopped.

How should families make this decision?

When deciding whether to start medication, it's important to compare the right things. Childhood obesity is a medical condition, not a cosmetic concern. Like all medications, GLP-1s have risks. The real question is whether those risks are greater or smaller than the risks of leaving obesity untreated. That balance is different for every child.

Some children benefit from more time focusing on nutrition, movement, sleep, and behavior change before considering medication. Others have already worked incredibly hard and may benefit from medication to reduce the biological barriers standing in their way.

Needing medication isn't a sign that your child didn't try hard enough. It's one evidence-based tool that can help treat a chronic medical condition when it's the right fit.

A good pediatric obesity clinician should explain every option, discuss the benefits and risks honestly, and help your family decide what gives your child the best chance of a healthier future.

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